Reimbursing Out-of-Pocket Medical Expenses: What You Need to Know

Remember, you did not have to be present on 9/11 and you did not have to be a First Responder to be eligible. The benefits of the Victim Compensation Fund (VCF) and the World Trade Center Health Program (WTCHP) are also available to office workers, construction and other trades, residents, teachers, students and others.

Anyone affected by the toxic air created by the events of 9/11, and not classified as a First Responder, even if your exposure was months later, is classified as a Survivor. 

Question: Can I get reimbursed for medical expenses that I paid out-of-pocket and were not covered by the WTC Health Program or reimbursed by my insurance?

Answer: Yes, you can request reimbursement for past out-of-pocket medical expenses related to your eligible condition(s) if they were paid before the date that the WTC Health Program certified your condition(s). However, there are specific criteria and procedures you need to follow when submitting a claim for reimbursement of medical expenses to the Victim Compensation Fund (VCF).

Eligibility Criteria

• Timing: Expenses must have been incurred before the WTC Health Program certified your condition(s).
• Verification: The claimed medical expenses must be related to your eligible condition and personally paid out of pocket.
• Minimum Amount: The total claimed medical expenses must exceed $5,000, and the VCF must be able to verify at least $5,000 of the claimed out-of-pocket expenses based on submitted documentation.

Submission Process

• Personal Injury Claim: Submit the claim for medical expenses as a compensation amendment only after receiving your initial award determination. This helps expedite the initial award process.
• Deceased Claim: Include the claim for medical expenses as part of your initial claim submission. Amendments are generally not permitted after substantive review of the compensation claim.
• Documentation: Submit the claim with the required documentation and in the specified format outlined by the VCF.

Important Considerations

• Processing Time: Claims for reimbursement of out-of-pocket medical expenses require significant documentation and review, which may delay your award.
• Discretionary Waiver: The Special Master may exercise discretion to waive certain requirements based on individual claimant circumstances. 
  

How We Can Help

At Cannata, Hendele & Cannata, LLP, we understand the complexities of navigating the VCF reimbursement process. Our experienced attorneys can provide guidance and assistance to ensure your claim is submitted correctly and efficiently. If you have incurred out-of-pocket medical expenses related to 9/11-related conditions, we are here to help you seek the reimbursement you deserve.

For more information or assistance with your VCF claim, please don't hesitate to reach out to us. Your health and well-being are our top priorities, and we are committed to helping you access the support and compensation you need. Contact us today to learn more.

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